RA

Question 1

Treatment for RA?

Answer 1

NSAID, DMARD and maybe steroid to get things started quicker

Question 2

Who should be tested for RA?

Answer 2

At least one joint with definite clinical synovitis

Question 3

What is the joint involvement of the classification criteria for RA?
How many points is each joint?
1 large joint, 2-10 large joints, 1-3 small joints, 4-10 small joints, greater than 10 joints with at least 1 small joint?

Answer 3

1,2,2,3,5

Question 4

What is the point allotment for serology, acute phase reactants, and duration of symptoms?

What is the magic score to definitely say RA?

Answer 4

No antibodies, 0. Low RF and CCP, 1. High RF and CCP, 2.

Normal CRP and ESR, 0. Abnormal CRP and ESR, 1

Under 6 weeks, 0. Over 6 weeks, 1.

Greater than 6/10.

Question 5

Genetic association for RA?

Answer 5

HLA DRB4

HLA DRB1 0401 or 0404

Question 6

What part of the spine is typically affected in RA?

Answer 6

C1-C2

Question 7

What is the swan neck and boutonnière deformity in RA?

Answer 7

Swan neck is hyperextension of PIP

Boutonnières is hyperflexion of PIP

Question 8

6 extra articular symptoms of RA?

Answer 8

Nodules, pyroderma grangrenosum (necrotic ulcer), vasculitis, CAD, pleural effusions, keratoconjuncvtivits because of secondary sjogren,

Question 9

What syndrome is commonly secondary to RA?
What is the problem?
What are the lab markers?
2 tests to evaluate for it?
Clinical features?

Answer 9

Sjogren syndrome
Autoimmune destruction of lacrimal and salivary glands
SSA Ro and SSB La antibodies
Slit lamp test and schirmers test
Dry eyes, dry mouth, vaginal dryness and tracheostomy’s bronchial dryness

Question 10

What is a second syndrome to know is part of RA and what are the 6 features?

Answer 10

Big spleen
Neutropenia
Fever
Anemia 
Low platelet
RF and anti CCP positive

Question 11

What is recommended as first DMARD to give for RA?

3 adverse effects of leflunomide?

Answer 11

Methotrexate

Gi/hepatic/teratogenic